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Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
Posttransplant nodular regenerative hyperplasia (NRH) mostly remains unexplained. Microvascular injury due to antibody-mediated rejection (AMR) is suspected, but lack of donor specific antibody (DSA) testing makes it difficult to prove. Centered around a 1-year period of routine DSA testing, concomi...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409867/ https://www.ncbi.nlm.nih.gov/pubmed/37565050 http://dx.doi.org/10.3389/ti.2023.11306 |
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author | Sebagh, Mylène Yilmaz, Funda Kounis, Ilias Saliba, Faouzi Feray, Cyrille Taupin, Jean-Luc Cherqui, Daniel Azoulay, Daniel Samuel, Didier Coilly, Audrey Demetris, Antony-Jake Neil, Desley |
author_facet | Sebagh, Mylène Yilmaz, Funda Kounis, Ilias Saliba, Faouzi Feray, Cyrille Taupin, Jean-Luc Cherqui, Daniel Azoulay, Daniel Samuel, Didier Coilly, Audrey Demetris, Antony-Jake Neil, Desley |
author_sort | Sebagh, Mylène |
collection | PubMed |
description | Posttransplant nodular regenerative hyperplasia (NRH) mostly remains unexplained. Microvascular injury due to antibody-mediated rejection (AMR) is suspected, but lack of donor specific antibody (DSA) testing makes it difficult to prove. Centered around a 1-year period of routine DSA testing, concomitant protocol, and indicated posttransplant liver biopsies (LB), recipients with NRH (n = 18) were compared with a matched control group (n = 36). All index, previous, and subsequent LB were reviewed. Both groups were similar in terms of demographics, timing of index LB, and DSA. In the index LB, the NRH group had higher sinusoidal C4d positivity (p = 0.029) and perisinusoidal fibrosis (p = 0.034), both independently associated with NRH (p = 0.038 and 0.050, respectively). Features of “possible” chronic AMR were detected in 28.5% of the NRH group without a known cause and 0% of the control group (p = 0.009). The NRH group had more preceding indicated LB with increased incidence of rejection and biliary obstruction pattern. In the follow-up histology, overall, sinusoidal and portal C4d positivity, sinusoidal microvasculitis, and perisinusoidal fibrosis were also higher (all p < 0.050). In conclusion, we provide evidence towards the hypothesis that some cases of posttransplant NRH are related to preceding active and persistent AMR. Large multicenter studies with protocol DSA testing are required to confirm. |
format | Online Article Text |
id | pubmed-10409867 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-104098672023-08-10 Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation Sebagh, Mylène Yilmaz, Funda Kounis, Ilias Saliba, Faouzi Feray, Cyrille Taupin, Jean-Luc Cherqui, Daniel Azoulay, Daniel Samuel, Didier Coilly, Audrey Demetris, Antony-Jake Neil, Desley Transpl Int Health Archive Posttransplant nodular regenerative hyperplasia (NRH) mostly remains unexplained. Microvascular injury due to antibody-mediated rejection (AMR) is suspected, but lack of donor specific antibody (DSA) testing makes it difficult to prove. Centered around a 1-year period of routine DSA testing, concomitant protocol, and indicated posttransplant liver biopsies (LB), recipients with NRH (n = 18) were compared with a matched control group (n = 36). All index, previous, and subsequent LB were reviewed. Both groups were similar in terms of demographics, timing of index LB, and DSA. In the index LB, the NRH group had higher sinusoidal C4d positivity (p = 0.029) and perisinusoidal fibrosis (p = 0.034), both independently associated with NRH (p = 0.038 and 0.050, respectively). Features of “possible” chronic AMR were detected in 28.5% of the NRH group without a known cause and 0% of the control group (p = 0.009). The NRH group had more preceding indicated LB with increased incidence of rejection and biliary obstruction pattern. In the follow-up histology, overall, sinusoidal and portal C4d positivity, sinusoidal microvasculitis, and perisinusoidal fibrosis were also higher (all p < 0.050). In conclusion, we provide evidence towards the hypothesis that some cases of posttransplant NRH are related to preceding active and persistent AMR. Large multicenter studies with protocol DSA testing are required to confirm. Frontiers Media S.A. 2023-07-26 /pmc/articles/PMC10409867/ /pubmed/37565050 http://dx.doi.org/10.3389/ti.2023.11306 Text en Copyright © 2023 Sebagh, Yilmaz, Kounis, Saliba, Feray, Taupin, Cherqui, Azoulay, Samuel, Coilly, Demetris and Neil. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Health Archive Sebagh, Mylène Yilmaz, Funda Kounis, Ilias Saliba, Faouzi Feray, Cyrille Taupin, Jean-Luc Cherqui, Daniel Azoulay, Daniel Samuel, Didier Coilly, Audrey Demetris, Antony-Jake Neil, Desley Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation |
title | Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation |
title_full | Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation |
title_fullStr | Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation |
title_full_unstemmed | Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation |
title_short | Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation |
title_sort | evidence for alloimmune sinusoidal injury in de novo nodular regenerative hyperplasia after liver transplantation |
topic | Health Archive |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409867/ https://www.ncbi.nlm.nih.gov/pubmed/37565050 http://dx.doi.org/10.3389/ti.2023.11306 |
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